胃壁细胞迷走神经切除和改良式选择性迷走神经切断加胃窦切除治疗十二指肠溃疡的短期观察

THE SHORT-TERM RESULTS OF PARIETAL CELL VAGOTOMY AND MODIFIED SELECTIVE VAGOTOMY WITH ANTRECTOMY FOR DUODENAL ULCER

本文报道30例胃壁细胞迷走神经切除术和50例改良式选择性迷走神经切断加胃窦切除术。术后胃液分析与术前的差异非常显著(P<0.001)。随访半年至3年半,近期疗效均属优、良。作者认为应严格掌握手术指征,食管下端至少要剥离5厘米以上,膈下食管旁置引流管可减少术后并发症的发生.

This article reports 80 cases of duodenal ulcer treated by parietal cell vagotomy(30cases)and modified selective vagotomy(50 cases)since 1978.There were 70 males and10 females with ages ranged 21-71 yr.The indications were intractable pain,pain withbleeding and pain with pyloric stenosis.All the cases were followed up for 0.5-3.5 yr.The results of these 80 cases were very satisfactory or better than that of 740 subtotalgastrectomies in our hospital.No recurrence of ulcer was observed so far.It is the au-thors’experience that the lower 5-7 cm esophagus must be dissected free and the para-esophageal space be drained for 24-72 hr in order to avoid postoperative dysphagia.